Kornimate/medical-research-clean huggingface dataset:
the effect of pramipexole on metabolic network activity compared with levodopa in early parkinson's disease

Conditions: Idiopathic Parkinson's Disease

Summary: levodopa and non-ergot dopaminergic agonists such as pramipexole are both recommended as the first-line symptomatic treatment for early untreated parkinson's disease (pd), previous clinical trial indicated that initial pramipexole owns advantage over levodopa regarding motor complications, on the contrary, less adverse effect like freezing and severe somnolence favors initial treatment of levodopa. thus, it remains controversial that initiation of which medication will be better for those patients with early pd. parkinson's disease-related spatial covariance patter (pdrp) is a new biomarker which can represent the network activity of brain and severity of pd. based on the literatures and our previous data, the investigators hypothesize that pdrp will be served as a biomarker to help us evaluate and compare the effect of levodopa or pramipexole on the progression of pd, which might be able to provide further evidence for clinicians to address the above critical issue.

calm-pd study found that pramipexole can reduce the occurrence of motor complication compared with levodopa used as initiative treatment, but it still remains debatable that initiation of which medication will be better for those patients with de novo pd. pdrp (parkinson's disease-related spatial covariance pattern) is a biomarker which can represent the network activity of cortico-striato-pallido-thalamocortical pathways and highly reproducible with stable network activity in individual subjects. the study published in "j neuroscience" in 2010 showed that the abnormal pdrp antecede the appearance of motor signs by about 2 years, indicating pdrp might be a very promising biomarker for identifying pd at its early stage. moreover, pdrp is able to represent the progression and severity of pd as well. it was reported that levodopa can reduce the pd-related network activity, and the degree of network suppression correlates with the clinical improvement. however, there is no study currently showing the impact of pramipexole on brain pdrp network compared with levodopa as initiative treatment.

Eligibility criteria:
inclusion criteria: * idiopathic parkinson's disease meeting united kingdom (uk) brain bank criteria * de novo * hoehn\&yahr staging (h\&y) i-ii exclusion criteria: * atypical parkinsonism * pregnant or breast-feeding women * those with abnormal liver/kidney function * those participating other clinical trials within 30 days before being enrolled for this trial.

Keywords: de novo parkinson's disease initial treatment pramipexole levodopa parkinson's disease-related spatial covariance pattern
transcranial direct current stimulation in children with autism spectrum disorder

Conditions: Autism Spectrum Disorder (ASD); Transcranial Direct Current Stimulation (tDCS); Electroencephalography

Summary: background: transcranial direct current stimulation (tdcs) is a form of non-invasive brain stimulation that has aroused increased interests in the past decade. not only that it is transient with little side-effects, and can be well-tolerated by children, it is also affordable and readily accessible, making it an appealing treatment option for autism spectrum disorder (asd). objective: (1) to assess the therapeutic effects of tdcs when combined with cognitive training for 10 consecutive weekdays on improving cognitive processing in children with asd, relative to control group receiving sham-stimulation, and (2) to evaluate the associated neural mechanisms underlying the treatment effect of tdcs on children with asd. methods: to assess the therapeutic effects of tdcs, 100 adolescents with asd (age 8-12 years) will be randomly assigned to active- (n=50), or sham- (n=50) tdcs groups. twenty-minute sessions of 1.5 ma tdcs stimulation to the left dorsolateral prefrontal cortex (dlprc) in conjunction with cognitive training exercise will be provided on 10 consecutive weekdays. eegs and neuropsychological tests will be administered before and immediate after the series of tdcs sessions. hypothesis: we hypothesize that children with asd who are randomly assigned to receive a montage of prefrontal tdcs, with cathode (inhibitory) placed over left dlpfc and anode (excitatory) over right supraorbital region) will evidence greater improvement in executive function (primary outcome) than children with asd who are randomly assigned to receive sham-tdcs. in addition to testing the primary clinical outcome, stated above, in planned exploratory analyses, we will also examine the effects of tdcs on secondary outcome measures of cognitive function, including information processing speed, working memory, inhibitory control, and cognitive flexibility; and conduct exploratory mediation analyses to better understand the potential neurophysiological factors underlying the therapeutic effects of tdcs. this will include e/i ratio as exploratory mediator variables. as these secondary analyses are exploratory, we will report them as such in presentations and published papers, and we will not draw definitive conclusions from them. rather, they will be used to better understand the potential impact of tdcs and the mechanisms underlying impact, and to inform future research.


Eligibility criteria:
inclusion criteria: * being 8-12 years old * diagnosed with asd given by registered psychiatrists or clinical psychologists according to the diagnostic and statistical manual of mental disorders-5th edition (dsm-5) criteria of asd * iq score above 60 * able to communicate in chinese exclusion criteria: * with severe motor dysfunctions * history of other neurological and psychiatric disorders or head trauma
comparison of blood cardioplegia and custodiol

Conditions: Mitral Insufficiencies; Myocardial Protection

Summary: thru the last 20 years it has been a discussion witch solution that gives the best myocardial protection during cardiac arrest by heart operations. * it has been a tendency that a blood based cardioplegia gives a better protection bye long ischemic times but it has not been possible too conclude in this matter. * the investigators have two groups of cardioplegia, the blood based and, the crystalloid based cardioplegia. * it has been done a lot of studies to see what kind of cardioplegia that gives the best myocardial protection. different temperature, different amount and content, retrograde or antegrade or both, contentiously and further on have been tested without a clear conclusion. * the investigators decided to make a study with a cohort of patients as homogenous as possible with a cross clamp time around 70 min. * adult patients' with a severe aortic stenoses without any other significant heart disease was included in our prospective randomised study. * patients with additional significant coronary artery disease (≥ 50% stenoses) were excluded from the study. * the investigators used the well known biomarkers ck-mb and troponin-t too evaluate the myocardial damage.

objective: myocardial protection during a cardiac arrest is mostly managed with cardioplegia. to day we normally used a blood or crystalloid based solutions. it has been published a lot of papers comparing the too groups with different results. to our knowledge no prospective, randomized study has compared modified st thomas based blood and crystalloid cardioplegia on the acknowledged markers (ck-mb, troponin-t) of myocardial damage during aortic valve replacement on patients without additional significant coronary artery disease. methods: 100 patients with aorta stenoses undergoing aortic valve replacement without significant coronary artery stenoses or other significant concomitant heart valve disease were included in the study. they were given antegrade cold blood or cold crystalloid cardioplegia delivered through the coronary ostia every 20 min throughout the period of aortic cross-clamp. ck-mb and troponin-t were compared between the two groups. published 2010 in the journal of thoracic and cardiovascular surgery.

Eligibility criteria:
the study protocol was approved by the local ethical committees. eligible for operation were: inclution criteria * patients with mitral regurgitation equal to or larger than grade 3 out of 4. * ablation for atrial fibrillation was the only concomitant procedure that was allowed in addition to mitral valve surgery and these patients were block-randomized to ensure equally many patients with ablation in the two groups of cardioplegia. exclusion criteria * patients with any other concomitant heart valve disease or coronary artery stenoses (≥ 50%) were excluded from the study. * age below 18 * pregnant

Keywords: ck-mb troponin-t
hypothalamic function before and after bariatric surgery

Conditions: Obesity; Diabetes

Summary: the purpose of this study is to determine the effect of gastric banding or gastric bypass on hypothalamic morphology and function, gut hormones and systems biology in obese subjects with and without type 2 diabetes.


Eligibility criteria:
inclusion criteria: * patients aged 35-65 years; * bmi \> 40 kg/m2; * bmi \> 35 and \<40 kg/m2 with co-morbidity, which is expected to improve after surgically-induced weight loss; * a history of longstanding obesity (\>5 years); * proven failed attempts to lose weight in a conventional way, or primarily successful weight loss with eventual weight regain; * intention to adhere to a postoperative follow-up programme. exclusion criteria: * bmi\> 50 or body weight \> 150 kg (because it is impossible to safely put people above this weight on a standard table for mri); * subjects with disease related obesity, i.e. cushing or medication related obesity; * use of medication known to affect glucose or lipid metabolism (i.e. prednisone) * monogenetic diabetes: mody, mitochondrial diabetes; * lada (adult-onset latent autoimmune diabetes); detected by c-peptide measurement on screening. * impaired renal function (serum creatinine \> 176 μmol/l); * leg ulcers, gangrene. * any genetic or psychiatric disease (e.g. fragile x syndrome, major depression) affecting the brain * any significant chronic disease * renal or hepatic disease * pregnancy * recent weight changes or attempts to loose weight (\> 3 kg weight gain or loss, within the last 3 months) * aerobic exercise more that 3 times 60 minutes a week * alcohol consumption of more than 28 units per week at present or in the past * recent blood donation (within the last 2 months) * recent participation in other research projects (within the last 3 months), participation in 2 or more projects in one year * contra-indications to operative procedures as regular in bariatric surgery * contra-indications to mri scanning

Keywords: obesity diabetes bariatric surgery
risk of recurrent venous thromboembolism after provoked venous thromboembolism

Conditions: Recurrent Venous Thrombosis

Summary: venous thromboembolism (vte) is a common disease with an incidence of 1-2/1000 persons per year. vte is a chronic disease with a considerable risk of recurrence. patients with unprovoked vte, i.e. vte in the absence of a temporary risk factor including surgery, cancer or immobilisation, have a high recurrence risk and indefinite anticoagulation is generally recommended. the recurrence risk of patients with vte provoked by a transient risk factor is regarded as low. discontinuation of anticoagulation after three months is recommended because the benefit of reducing the recurrence risk further by prolonged anticoagulation is outweighed by the bleeding risk. however, the newer direct oral anticoagulants are potentially associated with a lower bleeding risk than vitamin k antagonists. because they are also meanwhile widely available and are convenient there is a trend towards prolonging anticoagulation also in patients with a vte after a transient provoking factor. however, the definition of transient provoking factors is imprecise and a distinct categorization according to the risk of recurrence is lacking. preliminary evidence suggests that the recurrence risk varies considerably between the different transient provoking factors. in a prospective cohort study, the investigators will include patients with a deep vein thrombosis or pulmonary embolism provoked by a transient risk factor defined according to guidance of the scientific and standardization committee of the international society on thrombosis and haemostasis (kearon et al., j thromb haemost 2016; 14: 1480-3) after discontinuation of anticoagulation. the study endpoint is recurrent symptomatic vte.


Eligibility criteria:
inclusion criteria: * symptomatic uni- or bilateral proximal or distal deep vein thrombosis of the leg and/or symptomatic pulmonary embolism provoked by a temporary risk factor * scheduled to be treated with anticoagulants for at least 3 months exclusion criteria: * need for long-term anticoagulation * poor patient compliance * no consent to participate * vte during pregnancy
butorphanol mitigate emergence agitation in patients undergoing functional endoscopic sinus surgery

Conditions: Agitation

Summary: emergence agitation is one of the common postoperative complications after functional endoscopic sinus surgery（fess). the objective of present study is to explore the effectiveness of butorphanol in the alleviation of emergence agitation in patients undergoing functional endoscopic sinus surgery.

butorphanol is a mixed agonist-antagonist opioid with strong κappa-receptor agonist and weak mu-receptor antagonist activity. it is commonly used for the management of cancer, postoperative, gynecologic, and obstetric pain. additionally, butorphanol has less respiratory depression and sedation effects, which make it may become a good medicine to alleviate the agitation. however, there is no clinical evidence to confirmation of such effectiveness of butorphanol. the objective of present study is to explore the effectiveness of butorphanol in the alleviation of emergence agitation in patients undergoing functional endoscopic sinus surgery.

Eligibility criteria:
inclusion criteria: 1. age \>=18 years,\<=65years; 2. height 150-180 cm; 3. weight 55-80 kg; 4. signed the inform consent 5. american society of anesthesiologists classification i to ii 6. select to functional endoscopic sinus surgery exclusion criteria: 1. existing cerebral disease, or have a history of neurological and psychiatric diseases including alzheimer disease, stroke, epilepsy and psychosis; 2. several audition or vision disorder; 3. unwillingness to comply with the protocol or procedures. 4. can not communicated with chinese mandarin 5. existing bradycardiac arrhythmia（heart rate \<60 bpm for any reasons） 6. existing gastrointestinal ulcer 7. existing urinary incontinence 8. existing asthma or chronic obstructive pulmonary disease 9. allegory to butorphanol

Keywords: butorphanol functional endoscopic sinus surgery emergence agitation
piperacillin/tazobactam for empirical therapy of febrile neutropenia

Conditions: Febrile; Neutropenia; Hematopoietic Stem Cell Transplantation

Summary: neutropenia is very common in patients received hematopoietic stem cell transplantation, with median duration of about 14 days. in 2010 update, idsa recommended piperacillin/tazobactam as first-line mono-therapy for febrile patients with neutropenia of high risk. in china, the data of piperacillin/tazobactam for febrile neutropenia after hematopoietic stem cell transplantation is very limited. the current study will evaluate the efficacy of piperacillin/tazobactam compared with imipenem/cilastatin for febrile neutropenia after transplantation.

1. swab culture (skin, pharyngeal, nasal, anus) when administered into laminar flow room after transplantation. 2. randomize the febrile patients into 2 groups. 3. therapy group receive piperacillin/tazobactam, 4.5g q6h iv. control group receive imipenem/cilastatin, 0.5g q6h. duration will be 5-10 days.

Eligibility criteria:
inclusion criteria: * age 13-65 years * received autologous or allogeneic hematopoietic stem cell transplantation. * ecog score 0-1. * icf is available. exclusion criteria: * allergic to any therapy drug. * documented infection before neutropenia. * renal dysfunction. * suffering from central nervous system or mental disease.
theta-burst repetitive transcranial magnetic stimulation (tbs) of the right inferior frontal gyrus for treatment of nicotine dependence

Conditions: Tobacco Use Disorder

Summary: the purpose of this research study is to examine the effects of theta-burst transcranial magnetic stimulation on inhibitory control and smoking among adult cigarette smokers. in a double-blind, sham controlled trial, investigators will examine the effects of 12 sessions of ctbs on executive function and smoking behavior.


Eligibility criteria:
inclusion criteria: 1. 18-65 yrs. of age 2. smoke \> 5 cigarettes/day for ≥ 2 yrs, and expired carbon monoxide (co) concentration of ≥ 8 ppm 3. english fluency 4. functional vision (with corrective lenses as needed) exclusion criteria: 1. use of psychotropic and antiepileptic medications in the last month 2. presence of an untreated illness or serious medical condition 3. history of major neurological illness 4. contraindication to tms (history of neurological disorder or seizure, increased intracranial pressure, brain surgery, or head trauma with loss of consciousness for \>15 min., implanted electronic device, metal in the head) 5. any use of substances that lower seizure threshold 6. current or past psychosis 7. electroconvulsive therapy in last 6 months 8. unstable cardiac disease or hypertension, severe renal or liver insufficiency, or sleep apnea 9. bac greater than 0.0. 10. positive urine pregnancy test 11. any other concern that in the investigator's opinion would impact participant safety, study instruction compliance, or confound the interpretation of the study results
study of the laboratory-based evaluation of the degrees of activity of osteoarthritis

Conditions: Osteoarthritis

Summary: this study evaluates laboratory-based method to estimate the degrees of activity of medium and large joint osteoarthritis.

osteoarthritis (oa) is a chronic progressive disease, characterized by degradation of joint cartilage, synovial inflammation and joint dysfunction. this study evaluates laboratory-based method to estimate the degrees of activity of medium and large joint oa. samples of synovial fluid (sf) from the patients with the oa (icd-10 codes: m15, m16 and m17) will be assessed for t-cell subsets, msast cells, fibroblast-like synoviocytes (fls) and macrophage-like synoviocytes (mls) by flow cytometry. subpopulations of blood t-cells involved in the inflammation will also be assayed. standard clinical investigation will be performed and the results will be used to estimate the laboratory criteria or degrees of activity of medium and large joint oa.

Eligibility criteria:
inclusion criteria: * medium and large joint active osteoarthritis exclusion criteria: * refuse of patient to participate in the trial; * acute infectious diseases; * pregnancy/lactation; * intercurrent severe chronic diseases; * hiv, hepatites b/c; * active tuberculosis; * alcohol use disorder/drug addiction; * malignant neoplasms/leukemia.

Keywords: osteoarthritis flow cytometry synovial fluid
group intervention study for individuals with dysarthria following stroke and their carers in pakistan

Conditions: Dysarthria As Late Effect of Stroke

Summary: dysarthria is a common problem in pakistan. therefore the current study aims to translate the dysarthria communication tools into urdu language for better understanding the population and the problem

dysarthria is the inefficiency or restricted capability to form intelligible speech because of the inability of motor control on the speech structures. there are many therapeutic approaches in pakistan that are in use for the patients with dysarthria following stroke. one of them is one to one intervention which may include one dysarthria client along with the speech therapist. the therapist delivers step by step instructions to the client. the essential assessments are being held to initiate the treatment. the application of this intervention approach leaves some drawbacks, such as, the patients find it difficult to relate and adapt to the treatment offered. generalization also seems to be complicated. the patients express a lack in motivation and support. the other mode of approach is group intervention, in which multiple dysarthria clients along with their caregivers \& speech therapist are included. in the later one, there are greater chances of recovery for patients as they get peer support and build confidence through newfound friends, peer communication with realistic social setting, learning through teaching, increased awareness of skills and it is time constraints. the culture of practicing group sessions with dysarthria patients is lacked in pakistan, which intends to meet and compensate for all the drawbacks and lacks of one on one intervention. by including the dysarthria patients, therapist and the caregivers in the group intervention, there're greater chances of reduced anxiety for both patients \& caregivers regarding disorder \& its recovery.

Eligibility criteria:
inclusion criteria: 1. 40 to 70 years age ranges 2. history of dysarthria previous six monthes 3. primary level of education 4. functional hearing and visual ablities - exclusion criteria: 1. patient with age below 40 to 70 2. patients with diagnosis severe psychological illness 3. patient with developmental dysarthria 4. patient who come alone without any attendent

Keywords: stroke dysarthia intervention
milk supplementation and energy balance.

Conditions: Obesity; Osteoporosis

Summary: the aim of the project is to determine if milk supplementation during a caloric restriction program facilitates the lost of weight, improves the appetite control and attenuates the decrease of bone mineral content in low-calcium consumer women.

calcium deficiency is related to a higher risk of obesity. some studies showed a lost of weight by elevating the calcium consumption to reach the recommended level. milk supplementation could be a good alternative to reach this objective, but its impact on weight loss and on appetite sensations has not been verified. furthermore, losing weight leads to some negative consequences like a decrease of bone mineral content. considering the benefits of milk on bone health, a higher intake of this food product during weight loss could represent a healthy strategy.

Eligibility criteria:
inclusion criteria: * low-calcium consumer (less than 800 mg daily) * bmi between 27 to 42 kg/m2 * sedentary * healthy exclusion criteria: * in menopause * medications that alter the project's objectives * smoker * dietary supplement consumer * high alcohol or caffeine consumer

Keywords: milk calcium weight loss bone density appetite